Korean J Orthod.  2021 Sep;51(5):346-354. 10.4041/kjod.2021.51.5.346.

Chewing gum as a non-pharmacological alternative for orthodontic pain relief: A randomized clinical trial using an intention-to-treat analysis

Affiliations
  • 1Department of Preventive and Community Dentistry, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
  • 2Private Practice, Rio de Janeiro, Brazil

Abstract


Objective
To compare the effectiveness of ibuprofen, acetaminophen, and chewing gum for orthodontic pain relief and to assess if chewing gum can be a non-pharmacological alternative for orthodontic pain relief.
Methods
The study enrolled 106 patients of both sexes, aged ≥ 12 years, with body weight > 50 kg, and mild-to-moderate dental crowding in the upper arch. After randomization and allocation concealment, the intervention groups were either administered with ibuprofen (400 mg) or acetaminophen (500 mg) or chewed sugar-free chewing gum immediately after initial archwire placement and every 6 hours for 1 week if the pain persisted. The control group did not receive any pain relief. The pain was assessed on a 100-mm visual analog scale at rest and while biting down at T1 (2 hours), T2 (24 hours), T3 (2 days), T4 (3 days), T5 (7 days), and T6 (21 days). Statistical analyses were performed using the Kruskal–Wallis and post-hoc Mann–Whitney U tests (α = 0.05).
Results
The chewing gum group experienced more pain relief than the ibuprofen group at while biting down at T3 (p = 0.04) and at rest at T4 (p < 0.001). The chewing gum group reported more pain relief than the acetaminophen and control groups while biting down at T3 (p = 0.03 and p = 0.0006, respectively) and T4 (both p < 0.001).
Conclusions
Chewing gum can be a non-pharmacological alternative for orthodontic pain relief at 2 and 3 days after initial archwire placement.

Keyword

Pain; Ibuprofen; Acetaminophen; Randomized clinical trial

Figure

  • Figure 1 CONSORT flow diagram of the clinical trial. VAS, visual analog scale; ITT, intention-to-treat; PP, per-protocol.


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